AbstractBackground: House dust mite (HDM) allergen challenge in the Fraunhofer ECC using a novel technique to generate allergen atmospheres is safe and induces symptoms in patients with allergic rhinitis. Symptoms are reproducible but individual responses are highly variable. To optimize the recruitment of sufficiently sensitive subjects for clinical trials, we evaluated different diagnostic allergy tests to predict the individual response to HDM in the ECC.Method: Twenty-four patients (7f/17 m) with allergic rhinitis to HDM were included. Allergen-specific IgE (Der p1/ Der p2), a nasal provocation test (NPT) and an intracutaneous test (ICT) were performed prior to challenge. The outcome variable was the total nasal symptom score (TNSS), calculated as the sum score of obstruction, rhinorrhea, itch, and sneeze (subscore scale from 0 to 3), following a 3 h HDM challenge in the ECC.Results: None of the diagnostic tests was significantly correlated with the AUC0–3 of the TNSS. Der p2-specific IgE showed the best correlation (r=0.43, P =0.067) and also best discriminated in a classification model together with the level of sensitization (skin prick test) against trees and fungi/moulds. The NPT response and ICT using the same allergen preparation that was used in the ECC did not correlate with the TNSS.Conclusion: A high level of specific serum IgE against Der p2 or a large skin prick test response against trees were found to be related to a stronger individual response to HDM exposure in the ECC and could help to optimize the recruitment of subjects for ECC-related clinical trials.